Academy of Chiropractic’s Lawyers PI Program

Narratives 43

From the Desk of :
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

"Duties Under Duress"

*****Disclaimer/Warning: As always, this information is based upon your clinical findings and should NEVER be inflammatory. You do not want to get the reputation of pandering to the plaintiff lawyers because then the plaintiff community will NOT want to work with you. Many other self-anointed "personal injury specialists" will urge you to be as expansive as possible and you should do so at your own risk of having your reputation destroyed. Be factual and do not be afraid to report NOTHING when nothing exists. It will go a long way to furthering your career with the plaintiff community!

It is critical to report functional losses and what the injured can no longer do after a reasonable course of care has concluded. That doesn't change. However, most patients have certain activities that are more difficult to do than usual because of injury (ies) and that should also be documented. For duties under duress to exist, certain documented activities must exacerbate pain, which is the hallmark of this category.

Duties under duress are different from permanent functional losses, also known as "loss of enjoyment of life" as they are your permanent functional losses.

Duties under duress have 4 categories:

  1. Work
  2. Domestic: cooking, cleaning
  3. Household: lawn-mowing, painting
  4. Studies: anything that interferes with schooling at any level

Sample/suggested language could begin with:

WORK

I have lost enjoyment when performing my work as a result of the injury on DATE.

I was a (full time, part time, seasonal, etc...) employee at ________ and my duties are ________. Since the accident I have (resumed my job with the same duties, resumed my job with lighter duties, changed duties at the same job, changes employers and do a different job, i cannot work).

Since the accident I have lost my (status, job security, promotional prospects, my quality of work has lessened).

Please be very explicit and do not limit yourself as to describing what has changed.

DOMESTIC

I have lost enjoyment when performing my domestic activities due to the pain in my ___ as a result of the injury on (DATE).

I have experienced a loss of enjoyment with the following activities inside my home: (Laundry, dishwashing, vacuuming, washing windows, cleaning, preparing meals, etc...)

HOUSEHOLD ACTIVITIES

I have lost enjoyment when performing my household activities as a result of the injury on (DATE).

I have experienced a loss of enjoyment with the following activities inside my home: (painting, landscaping, mowing the lawn, trimming bushes, washing windows, gardening, taking out the trash, washing the car, any other external housework, etc...)

STUDIES

I have experienced a loss of enjoyment when performing the following educational activities as a result of the injury on (DATE).

I am attending (high school, college, etc...) and (am no longer able to attend school, have dropped to part time, have been forced to change schools, have been forced to change majors, have been getting lower grades).

The above are performing duties under duress. When your patient can no longer perform any of the above, it become loss of enjoyment of life, or persistent functional losses of what they can no longer do as a result of the injury and include all of the above plus additional areas to be discussed in a different section.

NOTE: There is no limit as to what can be reported under each of the above categories as every patient's has a unique life, although there are many common areas, ensure that it is specific to your patient. It is also acceptable to report in generalities if a patient cannot articulate specifics, as long as you can clinically correlate the duties under duress being reported.

If...the patient has a long list and there are no underlying pathologies, I personally would not create any report for obvious reasons.

Click HERE: For an in-depth explanation, please read the article writtne by James Mathis and Mark Studin